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Lifespan > Vision and Hearing > Flashcards

Vision and Hearing Flashcards

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1
Q

what is the leading cause of blindness in people over 50yo

A

age-related macular degeneration (AMD)

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2
Q

what is the process of light entering the eye

A

light enters cornea –> thru back of cornea –> thru aqueous humor (fluid filling the lens) –> thru the lens

cornea and lens focus light on macula (central foveal are of reina) –> in retina light converted to chemical and electrical impulses–> sent down optic nerve to brain

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3
Q

how does the eye change w age

A

it is an elastic organ that over time begins to collagenize in certain areas as well as undergo certain microvascular changes

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4
Q

what is considered low vision

A

visual acuity of 20/50 or worse that can’t be corrected w prescription lens or medical interventions, AND/OR loss that limits physical performance

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5
Q

what is visual acuity

A

capacity of eye to discriminate details of objects in visual field

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6
Q

what is the visual field

A

central or peripheral vision related to dec pupil size which limits amt of light that can reach retina
- extends laterally, inf, sup

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7
Q

what is depth perception

A

ability to perceive relative distance of objects in the visual field

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8
Q

what does it mean to be legally blind

A

visual acuity 20/200 or less, or visual field of 20deg or less in better eye

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9
Q

what is conductive hearing loss

A

dysfunction of external or middle ear that results in dec transmission of sound wave vibration

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10
Q

what is sensorineural hearing loss

A

damage to cochlea, organ of corti or 8th CN

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11
Q

what sensory changes are seen in the eye w aging

A

dec # of rods (light and dark)
dec pupil size & reactivity
flattened cornea
lens changes shape
thickening of retina
dec nuclei in outer layer of retina

loss of protein homeostasis, cell death and mitochondrial dysfunction

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12
Q

what sensory changes inc susceptibility of retina detaching

A

dec nuclei in outer layer of retina

loss of protein homeostasis, cell death and mitochondrial dysfunction

ciliary bodies become more collagenized

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13
Q

what sensory changes are seen in the ears with aging

A

atrophy of organ of Corti
loss of hair cells
loss of afferent neurons

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14
Q

what sensory changes in the ears leads to sounds of all frequencies becoming more muffled

A

atrophy of cochlear lateral wall
- decline in cochlear endolymphatic potentials –> dysfunction of cochlear amplifier

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15
Q

visual contrast sensitivity: what is it, how does it change w aging, functionality/implications

A

structural changes in lens and pupil relating to adapting to changes in light

light/dark adaptation slows with age

dec ability to drive at night
difficulty exiting movie theater in broad daylight

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16
Q

how does color perception change w age, why, and what is the functionality/implications

A

dec color perception and difficulty distinguishing b/w colors w shorter wavelengths (blues, greens, violets)

d/t changes in retinal cones and ganglion cells

difficulty discriminating dark furniture from dark rooms

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17
Q

what is presbyopia and what does this lead to

A

dec lens elasticity and ciliary ms strength –> causing eye strain esp w reading and dark conditions

leads to inability to focus on near objects (need for reading glasses)

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18
Q

what is presbycusis and what does this lead to

A

progressive, (B), and age related sensorineural hearing loss, primarily observed in high frequency range d/t cochlear degen

leads to dec speech comprehension w fast speech or when background noise present

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19
Q

what are 4 common age related eye diseases (pathological, not normal part of aging)

A

cataracts
age related macular degen
glaucoma
diabetic retinopathy

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20
Q

what are cataracts d/t

A

lens (which is normally high in protein) undergoes proteostasis (loss of protein homeostasis) causing lens to become stiff and unable to properly filter light

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21
Q

what is age related macular degen d/t

A

altered intercellular communciation

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22
Q

what is glaucoma d/t

A

mitochondrial dysfunction

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23
Q

what is diabetic retinopathy d/t

A

dysfunction of insulin signaling pathways that leads to dysregulation of nutrients

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24
Q

what are cataracts

A

clouding of lens that affects vision

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25
what are risk factors for developing cataracts
cigarette smoking UV light exposure DM high body mass index
26
clinical s/sx of cataracts
clouded, dim, low vision
27
how are cataracts treated
surgery opaque lens removed and replaced by artificial intraocular lens
28
what is the leading cause of curable blindness worldwide
cataracts
29
what is glaucoma and its pathophysiology
visual impairments and pathological changes of optic nerve caused by loss of retinal ganglion cells --> retinal ganglion cells project axons via optic nerve from eye to brain and vulnerable to age related changes can develop slowly or quickly
30
what are risk factors for glaucoma
age genetics African and Asian origin
31
what is the hallmark sign of glaucoma and what does it indicate
redness of eye - indicates inc intraocular pressure
32
how is glaucoma treated
w med that lowers intra-ocular pressure (IOP) given the correlation b/w IOP and retinal ganglion loss
33
what is the leading cause of incurable blindness
glaucoma
34
is glaucoma treatable and what happens if untreated
effective if dz dx in early stage - thru treatment sight may be maintained if untreated progression leads to severe dec of visual field and irreversible blindness
35
clinical s/sx of glaucoma
peripheral vision loss
36
what optic pathology is most closely related to aging
AMD - cataracts and glaucoma can be seen in younger pts w predisposing factors
37
what is the pathophysio of AMD
degen of photoreceptors causing degenerative lesions in retina (circulatory insufficiency plays a part)
38
what 2 optic pathologies is smoking cessation important in prevention
cataracts AMD
39
what are risk factors for AMD
aging tobacco genetics degree of pigmentation - light eyes at inc risk arterial HTN UV rays consumption of non-balanced diet
40
how is AMD treated
intravitreous drugs lasers dynamic phototherapy surgery these slow the progression of dz
41
clinical s/sx of AMD
loss of central vision in the fovea
42
dry vs wet AMD
DRY - majority of cases - characterized by lipid deposits beneath retina WET - progression of dry AMD as lipid deposits cause leaky vessels and eventual hemorrhaging - clinical presentation: acute, sudden, irreversible vision loss
43
what is diabetic retinopathy characterized by
micro aneurysms hemorrhaging of retinal vessels
44
what are risk factors for diabetic retinopathy
duration of diabetes level of glycemia presence of high bp dependence on insulin elevated serum lipid levels genetics
45
what visual pathologies does diabetic neuropathy inc the risk of
cataracts 2x risk for glaucoma
46
what is key in decreasing the progression of diabetic retinopathy
improving glycemic control
47
clinical s/sx of diabetic retinopathy
damage to many parts of eye vision loss blindness
48
what is onchocerciasis
river blindness infectious dz caused by parasitic filaria, deposition of larva in subQ tissue
49
s/sx of onchocerciasis
infectious larvae deposits in subQ tissue leading to: - acute dermatitis -> severe itching - eye inflammation, bleeding, other complications --> blindness
50
clinical s/sx of onchocerciasis
"halo vision" (like glaucoma) in early stages
51
what parasite is responsible for onchocerciasis
blackfly transmits dz in fertile riverside areas that are often uninhabited for fear of infection - central and sub-Saharan Africa - Yemen - Latin America
52
snellen chart: what does it assess, results
visual acuity poorer than 20/50 -> affects postural stability
53
R vs L eye dominance
R dominant in 2/3 of pop L dominant more common in people w migraines -> can affect balance
54
what is looked for in a smooth pursuits visual assessment
attention to eye mvmt range - can detect dec ROM
55
what is a peripheral vision assessment and what are the norms
when you perceive things in periphery of field of vision relative to nose - via confrontation method (temp, sup, inf) 90deg periph to central 50 deg sup to nasal 60 deg inf to nasal
56
what is a depth perception visual assessment dependent on
accurate convergence
57
what screen should you perform before a depth perception visual assessment
convergence testing - can look at foot eye coordination, ie kick a ball
58
what is a functional example of how altered depth perception may present in an older adult
turning too soon during a transfer to a chair
59
when is ocular toxicity seen
meds given in high doses or for long periods of time 1. methotrexate (MTX) - antifolate in CA - auto-immune dz (RA) 2. tamoxifen - blocks estrogen in breast CA 3. anti-malarials (ex: plaquenil)
60
what can ocular toxicity cause (2)
toxic retinopathy optic neuropathy
61
sensorineural vs conductive hearing loss: what is it, pronounced w which sounds, causes/risk factors, clinical presentation
SENSORINEURAL - dysfunction of inner ear - more pronounced w high pitched frequencies (F,S,T) - gradual or sudden loss - genetic, noise pollution, meniere's, aging, ototoxicity, DM - present w dec speech comprehension w fast speech or when background noise present CONDUCTIVE - dysfunction of outer or middle ear - across all frequencies - mechanical cause: impacted cerumen, foreign bodies, benign tumors, fluid - soft voice and dec hearing
62
treatment for conductive hearing loss and why
hearing aid - mechanical global amplification
63
parts to general hearing assessment
observation - signs of inflammation (redness, colored fluid) whispered voice and have them repeat back rub hands together
64
weber test: conductive vs sensorineural results
should hear equally conductive - hear more in affected ear sensorineural - hear more towards unaffected ear
65
rinne test: conductive vs sensorineural hearing loss results
should hear air longer 2:1 ratio conductive - hear better on bone than air sensorineural - air better than bone but <2:1 ratio
66
what does it mean that a medication is ototoxic
harmful SE of drugs/toxins influencing hearing (contributing to and/or exacerbating hearing loss) and balance functions of ear
67
what are examples of ototoxic meds
**antibiotics - gentamicin, vanco, streptomycin loop diuretics - furosemide chemo - cisplatin chemicals - CO, quinine, arsenic, Hg, EtOH, tobacco
68
what visual paths inc fall risk
low vision visual impairment visual loss + NM deficits (dec somatosensation, inc vibration sensation threshold)
69
how does low vision inc fall risk
greater difficulty reweighting other sensory cues -> negotiating obstacles, uneven surfaces, stairs -> diminished protective responses
70
what does hearing loss inc the risk of
frailty
71
how could visual or hearing paths impact driving as an ADL
dark adaptation - difficulty driving at night color discrimination - take longer to detect brake light hearing - unable to localize horns from other cars
72
what are strategies to adjust the environment for visual impairments
minimize glare inc lighting contrasting surfaces add a seat at entrance for don/doff garments large face clocks contrasting color foods and table settings colored electrical tape on grab bars well placed signs and visual cues
73
what is the most promising strategy for visual impairments
adjusting the environment
74
what are strategies to adjust the environment for auditory impairments
face to face communication - in foveal field more words w vowels - easier to emphasize announce changes in subject drapes & fabric that absorb sound
75
what is a main strategy to improve balance in someone w visual impairments
uptrain vestib and somatosensory systems
76
balance and strength treatment activities
yoga (somatosensation) tai chi (proprioceptive kinesthetic awareness technique) obstacle course w collision warning device stair climbing w high contrast edge highlighter on edge of each tread
77
what are examples of vision based tech
hand held spectacle or telescope floor lamp table magnifiers tactile dots on objects to localize
78
what is a telescoping lens
hand held or mounted on glasses can be monocular or binocular
79
what are low vision sunglasses
colors can help vision become less foggy - yellow and orange can improve contrast sensitivity
80
what are examples of auditory tech
hearing aids cochlear implants amplifiers
81
hearing aids: indications, limitations
conductive hearing loss small batteries difficult to manipulate hard to hear in loud rooms
82
cochlear implants: indications, how does it work, precautions
severe to profound hearing loss sound transmitted to impulses sent to cochlea and auditory nerve - prosthesis - magnetic to skull caution w modalities and infections
83
amplifiers: how does it work, limitation
speaker on device amplifies sound thru headphones (or Bluetooth) - frequency selective (aka higher frequency) while it is somewhat effective, less than hearing aids or cochlear implants
84
what is universal environmental design
approach to design that integrates products and building features that are usable by anyone regardless of their ability - most widely accepted theory for environmental design
85
what are examples of components to universal environmental design
fluorescent lighting appropriate draperies acoustic ceiling tiles indoor/outdoor carpet furniture contrasts w floor colored fixtures in bathroom
86
how is fluorescent lighting a component of universal environmental design
adequate illumination while minimizing glare
87
how are appropriate draperies a component of universal environmental design
sheers minimize glare certain fabrics absorb sound
88
how is the use of acoustic ceiling tiles a component of universal environmental design
allow for better speech discrimination
89
how is the use of indoor / outdoor carpet a component of universal environmental design
cushions falls minimizes friction vinyl is easier to clean but is a higher risk of injury w falls
90
how are colored fixtures in the bathroom a component of universal environmental design
minimizes glare and helps minimize the effects of poor depth perception
91
what are 5 major red flags and what do they likely indicate
CNS: - blurred/dec vision in one or both eyes - double vision - loss of speech or trouble understanding speech - nystagmus, ptosis, impaired pupillary response CV disorder: - severe HA

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